Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,251.85 / $8,251.10 / $9,475.98	Facility		$4,251.85	$8,251.10	$9,475.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $4,169.30 / $4,788.50	Professional		$4,128.02	$4,169.30	$4,788.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,160.03 / $7,636.84 / $9,205.48	Facility		$5,160.03	$7,636.84	$9,205.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $4,128.02 / $5,572.82	Professional		$4,128.02	$4,128.02	$5,572.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6,604.83 / $7,430.44 / $7,566.27	Facility		$6,604.83	$7,430.44	$7,566.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,128.02 / $5,867.41 / $10,733.77	Facility		$4,128.02	$5,867.41	$10,733.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $4,786.00 / $7,308.23	Professional		$4,128.02	$4,786.00	$7,308.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $4,128.02 / $4,540.82	Facility		$100.00	$4,128.02	$4,540.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $8,256.04 / $8,256.04	Professional		$39.54	$8,256.04	$8,256.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $4,125.55 / $4,538.10	Facility		$92.60	$4,125.55	$4,538.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $4,125.55 / $4,592.60 / $17,614.63	Professional		$4,125.55	$4,592.60	$17,614.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $92.60 / $4,128.02 / $4,540.82	Facility		$92.60	$4,128.02	$4,540.82
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $8,256.04 / $8,256.04	Professional		$39.54	$8,256.04	$8,256.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $4,436.54 / $12,334.00	Professional		$4,128.02	$4,436.54	$12,334.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $3,988.33 / $4,128.02 / $19,941.65	Facility		$3,988.33	$4,128.02	$19,941.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $7,339.43 / $17,614.63	Professional		$4,128.02	$7,339.43	$17,614.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $4,125.55 / $4,125.55 / $4,125.55	Professional		$4,125.55	$4,125.55	$4,125.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.49 / $5,795.74 / $5,795.74	Professional		$94.49	$5,795.74	$5,795.74
United Facility/Professional Professional Modifier Low / Median / High Price $4,128.02 / $4,251.85 / $4,912.34	Professional		$4,128.02	$4,251.85	$4,912.34